Anaesthesia
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Randomized Controlled Trial Comparative Study
A randomised trial comparing the i-gel (TM) with the LMA Classic (TM) in children.
We performed a prospective, randomised trial comparing the i-gel(TM) with the LMA Classic(TM) in children undergoing general anaesthesia. Ninety-nine healthy patients were randomly assigned to either the i-gel or the LMA Classic. The outcomes measured were airway leak pressure, ease of insertion, time taken for insertion, fibreoptic examination and complications. ⋯ A good fibreoptic view of the glottis was obtained in 74% of the i-gel group and in 43% of the LMA Classic group (p < 0.001). There were no significant complications. In conclusion, the i-gel provided a similar leak pressure, but a shorter insertion time and improved glottic view compared with the LMA Classic in children.
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Randomized Controlled Trial
The effect of short time periods of pre-operative warming in the prevention of peri-operative hypothermia.
The aim of our study was to evaluate the performance of different durations of active pre-operative skin-surface warming (pre-warming) to prevent peri-operative hypothermia and postoperative shivering. We randomly assigned 200 patients, scheduled for surgery of 30-90 min under general anaesthesia, to receive passive insulation or forced-air skin surface warming for 10, 20 or 30 min. Body temperature was measured at the tympanic membrane. ⋯ Without pre-warming, 38/55 (69%) patients became hypothermic (< 36 °C) at the end of anaesthesia, whereas only 7/52 (13%), 3/43 (7%) and 3/50 (6%) patients following 10, 20 or 30 min pre-warming, respectively, became hypothermic (p < 0.001 vs no pre-warming). Shivering was observed in 10 patients without, and in three, three and one patients with pre-warming in the respective groups (p = 0.02). Pre-warming of patients for only 10 or 20 min before general anaesthesia mostly prevents hypothermia and reduces shivering.
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Guideline
Checking anaesthetic equipment 2012: association of anaesthetists of Great Britain and Ireland.
A pre-use check to ensure the correct functioning of anaesthetic equipment is essential to patient safety. The anaesthetist has a primary responsibility to understand the function of the anaesthetic equipment and to check it before use. Anaesthetists must not use equipment unless they have been trained to use it and are competent to do so. ⋯ A two-bag test should be performed after the breathing system, vaporisers and ventilator have been checked individually. A record should be kept with the anaesthetic machine that these checks have been done. The 'first user' check after servicing is especially important and must be recorded.